Check Request Form

Check   R equest   F orm  

Thorson   E lementary   P TO  

Requested   b y:   ___________________________________    

Today's   D ate:   _ _______________________    

Account   t o   b e   c harged:  ____________________________    

Amount   r equested:   $   _________________    

 

Reason/comment/description   o f   e xpense:   _ ___________________________________________________    

  _ ______________________________________________________________________________________    

Itemized   ( receipt,   i nvoice,   v endor   p urchase   o rder   o r   o ther   d ocumentation   a cceptable   b y   t he   I RS   m ust  

accompany   t his   r equest.   C harge   r eceipts   a re   n ot   a ccepted   b y   t he   I RS.  

Make   c heck   p ayable   t o:   _ _____________________________________________    

Please   f orward   t he   c heck   a s   f ollows:  

 

____   S end   h ome   w ith   m y   c hild:   n ame   _____________     ____   P lace   i n   t he   P TO   f ile   u nder   t he   f ile   n ame:    

 

Teacher's   n ame     __________________________    

 __________________________________        

____   M ail   i n   t he   a ttached   s elf-­‐addressed   e nvelope  

Other:     _ ________________________________    

Requestor   s ignature:   _ ____________________________________________________________________    

Committee   C hair   s ignature:  ________________________________________________________________    

Date   p aid:   _ __   / ___   / ___     A mount   p aid   $   _ _________   Check   # :   _ ________   T reasurer:  _________________    

 

Check   R equest   F orm  

Thorson   E lementary   P TO  

Requested   b y:   ___________________________________    

Today's   D ate:   _ _______________________    

Account   t o   b e   c harged:  ____________________________    

Amount   r equested:   $   _________________    

 

Reason/comment/description   o f   e xpense:   _ ___________________________________________________    

  _ ______________________________________________________________________________________    

Itemized   ( receipt,   i nvoice,   v endor   p urchase   o rder   o r   o ther   d ocumentation   a cceptable   b y   t he   I RS   m ust  

accompany   t his   r equest.   C harge   r eceipts   a re   n ot   a ccepted   b y   t he   I RS.  

Make   c heck   p ayable   t o:   _ _____________________________________________    

Please   f orward   t he   c heck   a s   f ollows:  

 

____   S end   h ome   w ith   m y   c hild:   n ame   _____________     ____   P lace   i n   t he   P TO   f ile   u nder   t he   f ile   n ame:    

 

Teacher's   n ame     __________________________    

 __________________________________        

____   M ail   i n   t he   a ttached   s elf-­‐addressed   e nvelope  

Other:     _ ________________________________    

Requestor   s ignature:   _ ____________________________________________________________________    

Committee   C hair   s ignature:  ________________________________________________________________    

Date   p aid:   _ __   / ___   / ___     A mount   p aid   $   _ _________   Check   # :   _ ________   T reasurer:  _________________